Rabies virus is transmitted by bites from infected animals; for example: dogs, cats, monkeys, bats or others. Most mammals can be infected and infect others including humans. Bats are frequently infected, and infection through urine from bats in caves has been described. The virus is transmitted through a bite and the virus follows the nerve from the site of the bite to the brain, which may take days to months. A bite in the face is therefore more dangerous than a bite on a limb.
Vaccination is recommended for long-term travellers to areas with extensive rabies for example Africa, Asia and South- and Central America where there is no immediate access to rabies vaccine.
There are many vaccines by different manufacturers, but the most used in industrialised countries is a vaccine cultured in human diploid cells.
The primary vaccination schedule includes 3 injections given day 0, 7 and 28. The protection period is 5 years.
Previously vaccinated persons:
After exposure or sus-pected exposure two injections are given 7 days apart and rabies immunoglobulin is not used.
Vaccinations are started as soon as possible and six doses are administered day 0, 3, 7, 14, 28 and 90. The first vaccination is given together with rabies-immunoglobulin, RIB, 20 IU per kg bodyweight.
There are no symptoms in the incubation period. If the virus reach the brain and the symptoms begin, the infection is 100% lethal. The symptoms are decreasing consciousness, and seizures especially when trying to drink.
The virus can be found in the brain of infected animals.
Supportive only. No specific antiviral drugs available.
Vaccination. Children are a special risk group because they may be less wary of animals. Vaccinate animals in the households against rabies.
Rabies is found worldwide in animals. Human infections are almost exclusively seen in Africa, Asia, South- and Central America and Russia.